Collections Specialist Health Care

LaDonna Bardley

Email: *******.*@***.*** Cell: 501-***-**** Little Rock, AR 72205

OBJECTIVE: Seeking a Part –Time Custodian position.

SUMMARY: I am a seasoned Health Care Insurance Collections Specialist with 19 years’ previous experience, 10 years Retail Merchandising/reset experience.

Employment History

2014-Current

Merchandiser/Stock Clerk

Merchandisers ensure shelves are stocked, products are organized, and displays are visually appealing to attract customers

Merchandisers create and maintain displays, including setting up promotional materials and signs.

As a retail merchandiser, responsible for ensuring that the proper level of merchandise is maintained, and is displayed appropriately with proper signage and favorable shelf space

This includes setup, teardowns and plan-o-gram execution, as well as the stocking, facing, and rotating of the product

Read and understand plan-o-grams

Collect plan-o-grams, new item tags and new item product and prepare work area in order to complete section reset

Break down sections in an orderly manner to allow customers to shop other sections in that aisle

Re-position shelving and place product according to updated schematic

Clean up work area

Complete forms and report section completion to Kroger and immediate supervisors

Can work independently with little supervision

Be professional and helpful when dealing with customers

Maintain good relationship with store management team and staff

Comply with the guidelines established for KOMPASS employees, especially those regarding timeliness, productivity, teamwork, communication and clocking in/out guidelines

Practice safe lifting

During periods of reduced regular scheduled hours due to circumstances including but not limited to holidays or unforeseen urgent customer support needs, employees may be responsible for additional store support outside of their normal essential job functions

1999-2013

JOB SUMMARY: Medical Collection Specialist with 19 years prior experiences. Responsible for timely submission of secondary cross/over paper claims, monitoring claim status, researching rejections and denials, submitting 1st and 2nd level appeals, documenting related account activities, Submit adjustments request, Duties included collections of Medicare, Medicaid, Medicaid Managed Care, and Commercial Insurance payers. As a medical billing and collection specialist, I possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as Commercial insurance payer payment methods. Ability to submit contractual adjustments base on payer contracts agreements are regulations

MAJOR DUTIES Medical Collections/A/R Follow-up

Ensure timely collections of outstanding A/R

Contact patients and insurance companies to discuss outstanding balances and collect payments

Follow up on unpaid insurance claims, appeals, and denials to ensure timely payment

Resolve billing discrepancies and patient inquiries related to medical bills

Communicate effectively with patients, insurance companies, and healthcare providers to ensure smooth collections

Possess a basic understanding of medical billing and coding principles to ensure accurate billing and claim submission

Verify insurance eligibility, coverage, and benefits to ensure accurate billing and collection efforts

Knowledgeable in reading and understanding of the Explanation of Benefits (EOB’s) and understanding of patients liabilities copays, coinsurance, deductibles and denial codes.

Proficient customer service skills

Intermediate knowledge of MS Office. MS Outlook, AS400, Fax Machines, Copier, PC friendly

Perform insurance claim follow-ups for insurance denials and appeals

Contact insurance companies to check eligibility and benefits via phone or online portals

Received and processed subpoena for patient’s health information and or Itemized Billing Statements in accordance with Company and Facility policies and procedures

Some experience preparing new patients charts, gathering documents and information

Experience using online Third party payer provider portals to check claim status, gather any payment or denial information.

Willingness to learn

Contact this candidate